The government has yet to decide on when to offer coronavirus vaccines to children as it weighs up competing demands for the limited stock it procured for the adult population, a top health official said on Sunday.
SA’s medicines regulator announced on Friday that it had granted emergency-use authorisation for Pfizer’s coronavirus shot to be used in children as young as 12, but it is only the first step towards bringing them into the national inoculation programme. The government is offering jabs to anyone aged 18 and above and aims to reach 40-million people, or 70% of the adult population.
SA had by Saturday evening administered more than 14.67-million vaccine doses, but only 7.187-million people, or 17.9%, of the adult population were fully immunised.
“We do want to vaccinate children, but we need to get to the elderly and undocumented first,” said acting health director-general Nicholas Crisp.
“The number one priority is people over the age of 50. That is the group that is seriously at risk of ending up in hospital,” he said.
More than half (58%) of the 419,170 Covid-19 hospital admissions recorded to date in SA were people aged 50 or above, according to the latest daily surveillance report by the National Institute of Communicable Diseases. But coverage in this age cohort, particularly in Gauteng, the North West and Mpumalanga, remained worryingly low, said Crisp.
The health department procured 31-million doses of Johnson & Johnson’s single-dose shot, and 30-million doses of Pfizer’s double-dose jab. It has also received 7.8-million Pfizer doses donated by the US and has been allocated 1.39-million Pfizer doses by the international vaccine sharing mechanism Covax. However, these doses are sufficient to cover only the adult population, and no budget provision had been made so far for children, said Crisp.
The Pfizer jab is the only coronavirus vaccine approved for use in children in SA so far, according to SA Health Products Regulatory Authority (Sahpra) senior manager for pharmaceutical evaluations Silverani Padayachee.
Sahpra had directed Pfizer to update its package insert for the shot to include a warning about the risk of a heart condition, called myocarditis, in adolescents and young adults.
“There are signals of myocarditis, but it is rare. It is not possible to say who is likely to [develop] this condition, though people with a history of cardiac conditions may be more likely to do so. What we can say is that the risk of young people without a heart condition developing myocarditis is one in a million,” Padayachee said.
The Pfizer shot is already being offered to children aged 12 and above in the US, and the company is expected to seek regulatory clearance for younger children in the coming weeks. A growing number of countries are now offering coronavirus vaccines to children, including Cuba, which began immunising toddlers as young as two last week with its locally developed vaccines Soberana and Abdala. Chilean regulators approved Sinovac’s shot for children as young as six. Israel, Singapore, Hungary, France and Denmark began inoculating children from the age of 12 several months ago.
Last week, Crisp told parliament that vaccine coverage was lowest in Mpumalanga, with only 12.4% of its adults fully immunised, followed by the North West (14.3%) and Gauteng (14.5%). The Eastern Cape led the way with 22.5% of its adults fully immunised, followed by the Free State (20.9%) and the Western Cape (20.5%).
Gauteng was particularly concerning because it is SA’s most populous province and is the country’s economic centre, said Crisp.
Gauteng is home to 15.4-million people, or 25.9% of the SA population, according to Stats SA’s 2020 midyear population estimate.
“We are trying to get leadership across the board involved in initiatives to generate demand. We need everybody to understand why this is important if we want to get our lives back to normal,” said Crisp.
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